Fig. 8.41 Visual inspection of the target zone (opposite iridocorneal angle) by a four-mirror gonioscopic lens

trabecular meshwork and SchlemmÕs canal, forming a deep sclerotomy (i.e., ÒthalamiÓ) 0.3 mm high and 0.6 mm wide (Figs. 8.42 and 8.43). This procedure is repeated four times within one quadrant. Healon GV is evacuated from the anterior chamber with bimanual irrigation/aspiration (Fig. 8.44).

8.3.4Postoperative Management and Medication

Postoperative treatments include topical antibiotics and corticosteroids three times a day for a month and topical 2% pilocarpin three times a day for 10 days. The corticosteroids should be tapered after a few weeks to preventsteroid-inducedocularhypertension.Depending on the clinical assessment they can be followed by nonsteroidal inßammatory drugs, three times a day for 2Ð3 months after surgery.

Fig. 8.42 Penetration of the high-frequency tip

Fig. 8.43 Penetration up to 1 mm nasal into the sclera through the trabecular meshwork and SchlemmÕs canal

8.3.5Outcomes and Comparison with Other Techniques

This technique has been performed on patients suffering from open-angle glaucoma (53 eyes) or juvenile glaucoma (5 eyes). The mean age was 72.3 (±12.3) years [mean (±SD)] for the open-angle glaucoma and 9 (±1.4) years for the juvenile glaucoma. For all patients the follow-up was 72 months. The mean preoperative IOP was 25.6 (±2.3 mmHg) (range18Ð 48 mmHg) for patients with primary open-angle glaucoma and 39.6 ± 2.3 mmHg (range 34Ð46 mmHg) for patients with juvenile glaucoma. Mean IOP after